Botox or Dermal Fillers – What should you choose?

Botox or Dermal Fillers? What should you choose? – Guest Post from Dr Michel Lauzel

How the ageing process affects our skin

As we age skin loses its smoothness, fullness and elasticity which leads to the appearance of lines, wrinkles or folds. The natural ageing process results in a:

– Loss of volume (fat)

– Loss of hyaluronic acid

– Loss of hydration

– Loss of collagen

– Laxity of muscles

The effects of the ageing process on the skin are increased by a number of environmental factors such as the sun (UV damage), gravity, smoking, alcohol, poor diet and hydration and sun beds.

Modern society is less accepting of signs of ageing – particularly the face we present to the world.

Due to a culture of youth, in the media and in the workplace, there is increasing pressure on women in particular to look younger for longer. Are there things we can do to improve the signs of ageing and hold back time?

What are the treatment options?

Amongst the different rejuvenation treatments available to counter the ageing process, cosmetic creams mostly don’t live up to their promises mainly because they can’t penetrate far enough to reach the deeper levels of the skin. And for most people surgery seems like a step too far.

There is however an effective middle route with anti-wrinkle injections and dermal fillers. These treatments are injected directly into the skin and offer the best option to restore a firmer, toned, healthy looking skin and smooth out lines and wrinkles.

Anti-wrinkle injections

Better known as ‘Botox’ these injections temporarily block the contraction of the muscles below the skin and by relaxing these muscles they effectively iron out and soften the lines and wrinkles caused by smiling, frowning and other facial expressions.

Anti-wrinkle injections are mainly used in the upper face to treat three areas where expression lines appear and typically provide a fresher look:

1. Crow’s feet

2. Frown lines

3. Horizontal forehead lines

They can also be used to treat other lines and wrinkles including bunny lines, smoker’s lines and to create a brow lift.

These injections have been used safely for medical treatments for over forty years, and can also be used to treat excessive underarm sweating. The treatment is relatively painless and the effect typically lasts between 3 to 6 months.

Dermal fillers

Dermal fillers consist of a smooth gel which is injected to replace the loss of volume in the face resulting from the ageing process and they lift the skin, improving the wrinkles and sagging.

The latest generation of fillers (such as Restylane or Juvederm) contain Hyaluronic acid, a natural substance present in the skin which bonds with water molecules to increase deep hydration and add to the plumpness.

Revitalising and improving skin elasticity, hydration and smoothness for the face, hands and decolletage area.

These hyaluronic based fillers have proven to be very safe, based on the experience of millions of patients treated worldwide. Generally the effect lasts between six and nine months.

Working closely with your practitioner, treatments can be used to create a natural, more youthful look. The aim is to look better not ‘done’ and retain your own facial expressions and personality. We can’t avoid ageing but we can soften its effects and the face we present to the world.

What should you expect during the treatment itself?

1. Make you sure you have a detailed discussion with your practitioner and you are clear about the effects you can expect from your treatment. A visual examination of your face, its movement and lines should be conducted by the practitioner and prescriber of the botulinum toxin.

2. Make sure your medical history is discussed in full, and that you have no underlying conditions which could make you unsuitable for treatment. You may find that your practitioner will always ask you to sign a consent form and take photos before (and after) treatments. This is completely normal.

3. Don’t be afraid to ask questions, and remember it is a medical consultation and don’t feel pressured into having the treatment if you’re not sure about it.

4. No topical anaesthetic will be used for anti-wrinkle injections such as botox, although sometimes you may be given an icepack to place on the area prior to treatment. The area to be injected will be wiped with antiseptic and then using micro needles, tiny amounts of the botulinum toxin, will be injected into several points in the areas to be treated. For most people this is entirely painless and just feels like a ‘pinprick’.

5. Dermal fillers requite a topical anaesthetic, which is normally applied to the area to be treated 15 to 20 minutes beforehand. To make the patient experience even more comfortable, some fillers also have anaesthetic mixed with the filler inside the syringe.

6. Less is often more, and a good practitioner would prefer to see how you react to the treatment on your first visit, and offer a follow-up visit two weeks later with a ‘top-up’ if necessary.

7. Repeat treatments are normally needed around every 3 – 6 months to maintain the effects of the treatment.

8. The treatment and consultation usually takes no longer than 30 minutes and you are usually able to drive immediately afterwards and carry on with your day. It is not recommended that you lie down within 4 hours of the treatment, or embark in strenuous exercise on the day of treatment.

9. Following your anti-wrinkle injections (botox) you will not see any change for 2-4 days, with the treatment taking full effect between 7-14 days . The results last on average for 4 months. With fillers, the results are immediate, although it is advisable for the initial swelling at the injection site to go down to see the final result. It is not advisable to have treatment too close to a special event as some patients may experience bruising.

10. Anti-wrinkle injections such as botox are normally priced per number of areas treated. Eg Forehead lines classed as one area, crow’s feet (both eyes) a second area etc. Dermal fillers are priced per syringe which vary in size. To give an accurate cost of your treatment for dermal fillers- your practitioner will need to assess in person how much filler will be required for your specific treatment, and therefore the price.

Important questions to ask your practitioner

1. Are you a healthcare professional registered with the General Medical Council, General Dental Council or Nursing and Midwifery Council?

IMPORTANT: Always, always, always visit a reputable trained aesthetic healthcare practitioner who is experienced in facial injectable treatments. Ask ‘How long have you been trained in this area and do you have a certificate of accreditation?’

IMPORTANT: It is vital that the aesthetic healthcare practitioner has been trained to administer facial injectable treatments. Great results achieved with wrinkle relaxing injections are dependent on the technique of the practitioner – training and precision are essential when carrying out such delicate procedures. Don’t be afraid to ask for proof of their experience and training in facial injectables.

2. What products are you recommending to me and why?

IMPORTANT: If you want a specific product, ask for it by name. If you don’t have a particular brand in mind, then your practitioner should always provide an explanation for the brand of treatment they intend using.

3. Can I see the original packaging so I am assured of receiving the genuine product?

IMPORTANT: You may see the original packaging of the injectable treatment you are receiving. However, if it’s not visible to you, just ask to see the packaging so you know you are receiving the authentic product you have either asked for or been advised you will be receiving. Ask for the patient information for the products as well.

4. What are the possible risks or complications with these treatments?

IMPORTANT: Your practitioner should talk you about the risks of the non-surgical treatments in detail prior to treatment.

5. What level of aftercare will I be entitled to following my treatment?

IMPORTANT: Most professional aesthetic healthcare practitioner should offer a complimentary follow-up appointment, particularly on your first treatment. This will be a good opportunity to highlight any concerns you may have.

BIO:

Dr Michel Lauzel is a French fully qualified medical doctor specialising in non-surgical aesthetic treatments (Harley Street trained). He is registered with the GMC in the UK. He runs a number of successful clinics at salons/spas in Berkshire, Bedfordshire, Dorset, Hampshire, Hertfordshire and Middlesex.